Data from the New Hampshire Insurance Department shows the number of people who enrolled in the health insurance marketplace this year decreased by 4.1%. Roughly 73,090 people enrolled in the health insurance marketplace for 2026.
That’s down from about 76,251 in 2025, which the department said was a record-breaking year for ACA enrollment in a 2025 press release, and follows several years of growth in the number of Granite Staters using the health insurance marketplace.
Marketplace plan sign-ups had been increasing in New Hampshire since the pandemic, according to data from the Centers for Medicare & Medicaid Services. At the end of 2025, subsidies put in place during the pandemic that help offset the cost of health insurance on the marketplace expired.
Andrew Demers, a spokesperson for the New Hampshire Insurance Department, said the decrease was relatively stable, despite the Trump administration's decision not to extend health insurance tax credits. He attributed this stability to the fact that New Hampshire had the lowest ACA benchmark premiums in the country.
Read our coverage about the loss of Medicare options in New Hampshire in 2026.
The rate of people without insurance in New Hampshire was 4.5% in 2024. The Congressional Budget Office, Congress’s nonpartisan budget agency, predicts that by 2028, the number of people in the United States without health insurance will increase from 7.6% in 2025 to 10.1% in 2028.
Demers said the state measures affordability indicators, including premiums, deductibles, cost-sharing, and enrollment trends.
“Those measures continue to show that New Hampshire has one of the most competitive and affordable individual insurance markets in the country, although affordability remains a challenge for many families because healthcare costs continue to rise nationwide,” Demers said.
New Hampshire is not alone in the decrease in enrollment. Nationally, according to a report released by KFF last month, the number of people enrolling in ACA plans during open enrollment dropped by over a million in 2026, the largest drop-off since the marketplace launched.
That report used data from the Centers for Medicare & Medicaid Services (CMS), state-based marketplace and KFF survey data. It also shows that the neighboring state of Massachusetts saw growth in their marketplace enrollment. The state invested $250 million from a special state trust fund to offset the end of federal health insurance subsidies.
Connecticut also saw an increase in sign ups and also put state funds towards compensating the loss of federal subsidies.
